[Pheochcromocytoma, report of 10 cases]

The pheochromocytoma is a rare endocrine tumor, issued from the chromaffine surrenalian or extra-surrenalian tissue. We report a retrospective study of 10 cases of pheochromocytoma collected during a period 3 years. Our study concerned 3 men and 7 women, with an average age of 32, 5 years. Revealing symptomatology was dominated by an arterial hypertension [8 cases]. The triad of Menard [headaches, sweating and palpitations] was found in 6 cases. The biological assessment found a rise in the urinary catecholamine. Complementary exams [ultrasonography, tomodensitometry, magnetic resonances] were usefull for the location of the tumor. The adenalectomy realised by transperitoneal under costal way was realised in all the cases. Histological examination confirmed the diagnosis. The pheochromocytoma is a neuroendocrine tumor of neuroectodermic origin. The clinical and biological presentations depend on the importance of the hypersecretion of catecholamines. The treatment is surgical. The objective of this study is to insist on the rarity of this pathology, the diagnostic difficulties, the severity of this pathology and curability of the benign forms

unusual renal ttimor: low-grade mucinous tubular and spindle cell carcinoma

Low-grade mucinous tubular and spindle cell carcinoma is a rare tumor which was described in the 2004 OMS Classification as a new entity. We report the case of a 42-year-old female patient presenting with chronic lower back pain on the left side. On CT scan a left renal mass of 10 cm in diameter was seen, and the patient underwent left radical nephrectomy. Macroscopic examination of the resected organ revealed a well-defined, fleshy, partly hemorrhagic and necrotic tumor on the medial aspect of the kidney, measuring 8.2 cm in diameter. Microscopic evaluation confirmed the diagnosis of a non-infiltrating mucinous tubular carcinoma with spindle cells not invading the hilum. Histopathologic studies revealed positive staining for CK [KL1], CK7, CK20, EMA, vimentin and CD 15 and negative staining for CD 10. Our case report of this rare entity aims to draw the attention of pathologists and clinicians to the importance of its diagnosis, in view of its favorable prognosis

Renal hydatid cyst: Retrospective analysis of 15 cases

To analyze of the various epidemiological, clinical and therapeutical aspects of renal hydatid cyst. In this retrospective study we evaluated 15 cases of renal hydatid cysts treated at the Urology Department of Ibn Rochd University Hospital, Casablanca, between January 2004 and December 2007. The patient group consisted of 7 men and 8 women with a mean age of 40 [range 23-70] years. The parameters studied included the presenting symptoms, the findings on clinical and radiological investigations and the methods of treatment. The patients presented within a mean period of 14 months from the onset of symptoms. Presenting symptoms included pain, hydaturia, hematuria and the presence of a tumoral mass on palpation. Intravenous urography [IVU] revealed calcifications in one patient, a mass lesion in two patients and a non-functioning kidney in one patient. A CT scan of the abdomen was carried out in 6 patients where the radiological examination was inconclusive. However, all patients were subjected to ultrasonography, which remains the diagnostic modality of choice. Hydatid serology was positive in 8 patients. Treatment consisted of unroofing of the cyst in 13 patients and pericystectomy and nephrectomy in one patient each. During the post-operative period 2 patients developed urinary fistulae. After a follow-up of 30 months all patients are symptom-free. In the Maghreb region, where hydatidosis is endemic, the kidneys are rarely affected. The diagnosis of renal hydatid cysts mainly depends on sonography. CT scan is useful in cases with doubtful diagnosis. Magnetic resonance imaging [MRI] is the modality of choice in cases with atypical forms and helps in differentiating a renal hydatid cyst from a serous cyst or cystic renal cancer

new case of intrascrotal cystic lymphangioma

Cystic lymphangioma of the scrotum is a rare benign tumor of the lymphatic system with very few cases described in the literature. We report the case of a 23-year-old patient admitted to our service with the presumptive diagnosis of a right-sided hydrocele. Surgical exploration revealed a moderately sized multi-septated hydrocele, chronic inflammation and thickening of the tunica vaginalis and a small cystic mass 1 cm in size near the head of the epididymis, but separate from it, the testis and the spermatic cord. Treatment consisted of surgical excision of the mass and resection of the tunica vaginalis. Histological examination revealed a cystic lymphangioma. The objective of this article is to report the clinical presentation, diagnostic and therapeutic aspects of scrotal cystic lymphangiomas

[Squamous cell carcinoma of the pelvis presenting as pyonephrosis. A case report and review of the literature]

Squamous cell carcinoma of the renal pelvis is a rare tumor with a poor prognosis, mainly occurring in patients with neglected and secondarily infected pyelocalyceal stones. We report a new case of a 45-year old man who presented with features of pyonephrosis and was subjected to nephrectomy. Post-operative histological evaluation revealed an unsuspected squamous cell carcinoma of the renal pelvis. The patient died 3 months after the operation. Based on our observation and a review of the literature, we discuss the etiopathogenesis, histological, clinical and therapeutic aspects of this pathology

[Vaginal flap urethroplasty in the treatment of urethral destruction of obstetric origin]

Objective: Urethral destruction of obstetric origin is frequent in North Africa. The objective of this study was to evaluate the results of urethral repair by vaginal flap in women affected by urethrovaginal fistulae

Patients and Methods: From January 1998 to December 2001, five patients were subjected to urethroplasty by vaginal flap mobilized from the anterior vaginal wall. The patients' age ranged from 30 to 45 years; all were primiparous with obstetric urethrovaginal fistulae revealed by permanent urinary leakage. The closures were realized in two continuous sutures of PDS 4/0 on a urethral catheter of 16 Fr. The ablation of the catheter was practised on the 10th postoperative day

Results: Urinary continence was achieved in four patients. The remaining patient had stress urinary leakage corrected by colposuspension. Recovery with good results was noted in 80% of the cases

Conclusion: This technique allowed us to achieve an improvement of the quality of urethral repair. Being an easily performed technique, it allows at the same time to achieve elegant, effective and reliable results

[Fracture of the corpus cavernosum: report on 123 cases]

Objective: To analyze the diagnostic and therapeutic aspects of fracture of the corpus cavernosum and compare our results with those in the literature

Patients and Methods: Between January 1976 and June 2002, 123 cases of fracture of the corpus cavernosum were treated at our department. The mean age of the patients was 25 years. In the majority of cases [71.5%], fracture of the penis occurred by forced manipulation of the erected penis. The diagnosis was based on clinical examination. The patients were treated surgically by repair of the tunica albuginea, mostly [74 cases] after degloving of the penile skin. One case of ureteral rupture was encountered after fracture of both corpora cavernosa

Results: In 95 patients, the postoperative outcome was satisfactory. However, 8 cases of fibrous plaques and 4 cases of penile curvature were encountered. None of our patients experienced postoperative erectile dysfunction

Conclusion: Fracture of the corpus cavernosum is a pathology which remains quite rare. The diagnosis is based on clinical examination and treatment is surgical in the majority of cases. The outcome of the treatment of such fractures is usually satisfactory provided the patients present at an early stage